The trouble with belly fat is that it's not limited to the extra layer of padding located just below the skin (subcutaneous fat). It also includes visceral fat — which lies deep inside your abdomen, surrounding your internal organs.

Regardless of your overall weight, having a large amount of belly fat increases your risk of:

Cardiovascular disease

Type 2 diabetes

Colorectal cancer

Sleep apnea

Your weight is largely determined by how you balance the calories you eat with the energy you burn. If you eat too much and exercise too little, you're likely to pack on excess pounds — including belly fat.

However, aging plays a role. As you age, you lose muscle — especially if you're not physically active. Loss of muscle mass decreases the rate at which your body uses calories, which can make it more challenging to maintain a healthy weight. In addition, in some men fat cells in the arms and legs lose the ability to store fat, which causes any excess fat to go to the abdomen.

Your genes also can affect your chances of being overweight or obese, as well as play a role in where you store fat.

Drinking excess alcohol can cause you to gain belly fat — the "beer belly." However, beer alone isn't to blame. Drinking too much alcohol of any kind can increase belly fat, although some research suggests wine might be an exception.

If you drink alcohol, do so only in moderation. The less you drink, the fewer calories you'll consume and the less likely you'll be to gain belly fat.

So how do you know if you have too much belly fat? Simply measure your waist:

Stand and place a tape measure around your bare stomach, just above your hipbone. If your belly droops, lie down to take the measurement.

Pull the tape measure until it fits snugly around you, but doesn't push into your skin.

For men, a waist measurement of more than 40 inches (102 centimeters) indicates an unhealthy concentration of belly fat and a greater risk of health problems.

You can tone abdominal muscles with crunches or other targeted abdominal exercises, but just doing these exercises won't get rid of belly fat. However, visceral fat does respond to the same diet and exercise strategies that can help you shed excess pounds and lower your total body fat. To battle the bulge:

Eat a healthy diet. Emphasize plant-based foods, such as fruits, vegetables and whole grains, and choose lean sources of protein and low-fat dairy products. Limit saturated fat, found in meat and high-fat dairy products, such as cheese and butter. Choose moderate amounts of monounsaturated and polyunsaturated fats — found in fish, nuts and certain vegetable oils — instead.

Keep portion sizes in check. Even when you're making healthy choices, calories add up. At home, slim down your portion sizes. In restaurants, share meals — or eat half your meal and take the rest home for another day.

Include physical activity in your daily routine. For most healthy adults, the Department of Health and Human Services recommends moderate aerobic activity, such as brisk walking, for at least 150 minutes a week or vigorous aerobic activity, such as jogging, for at least 75 minutes a week. In addition, strength training exercises are recommended at least twice a week. If you want to lose weight or meet specific fitness goals, you might need to exercise more.

To lose excess fat and keep it from coming back, aim for slow and steady weight loss — up to 2 pounds (1 kilogram) a week. Consult your doctor for help getting started and staying on track.

Remember, you can lose belly fat — it just takes effort and patience. In fact, shedding even a few extra pounds can help you feel better and lower your risk of health problems.

References

Jacobs EJ, et al. Waist circumference and all-cause mortality in a large US cohort. Archives of Internal Medicine. 2010;170:1293.

Coutinho T, et al. Central obesity and survival in subjects with coronary artery disease: A systematic review of the literature and collaborative analysis with individual subject data. Journal of the American College of Cardiology. 2011;57:1877.

Coutinho, T, et al. Combining body mass index with measures of central obesity in the assessment of mortality in subjects with coronary disease: Role of 'normal weight central obesity.' Journal of the American College of Cardiology. 2013;61:553.

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